Risk factors for fragility fractures in patients with rheumatoid arthritis.

This study explored the risk factors for fragility fractures in patients with rheumatoid arthritis (RA). The authors concluded that aging, disease-related factors, and previous fracture history are important risk factors for fragility fractures in these patients.

RA is a chronic, systemic inflammatory disease that affects joints and causes bone loss. Patients with RA are at a higher risk of developing osteoporosis. Osteoporosis is associated with bone mass depletion and bone destruction that leads to fragile bones (fragility fractures). Fragility fractures commonly happen after a fall during daily activities and affect the quality of life of patients. They are also linked to immediate and long-term mortality risks.

RA medications can assist in the control of disease activity, improve functional disability and offer bone loss protection. Despite these treatments, non-vertebral fractures have been observed in some patients. Several factors have been identified as predictors of bone breaks along previously united fracture lines (refractures) in patients on long-term treatments to increase bone strength. However, risk factors for fragility fractures remain unclear in patients with RA in a real-world setting.

This study included a total of 477 patients with RA. 103 patients were placed into group 1 (new fractures), and 374 patients into group II (no new fractures). Patients were followed up for 3 years.

New fractures were associated with aging, additional medical conditions, a higher disability score, lower bone mineral density (BMD) at the hip bone, longer disease duration, higher FRAX score (a standardized score for determining the risk of hip or major bine fractures), and previous fractures. A previous fracture was the only risk factor that significantly increased the risk of another fracture by 2.17 times in patients with RA.

The study showed that a previous fracture is a major risks factor for fragility fractures in patients with RA.

This study reported partial findings of a larger study.